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At least 469 records · Page 26Linked to original sources
PubMed1998

Results of cavity reconstruction with hydroxyapatite implants after 15 years.

OBJECTIVE: The results of the first cohort of 60 cavity reconstructions with hydroxyapatite with a minimum follow-up period of 15 years were studied. STUDY DESIGN: The study design was a retrospective study. PATIENTS: A total of 60 patients had a follow-up period of >15 years. In four patients, not all data were available. Therefore, 56 patients were included in the study. They had a combination of cavity problems and hearing loss. INTERVENTION: The ear canal was reconstructed with a canal wall prosthesis of porous hydroxyapatite. The ossicular chain was reconstructed with an incus or incus-stapes prosthesis of dense hydroxyapatite. RESULTS: After 15 years, 42 patients (75%) had an intact reconstructed ear canal. The main problem for failure was the recurrent purulent middle ear infection and not cholesteatoma. The histology of the retrieved canal wall showed a good remodeling in living bone tissue. After 15 years, 34 patients had a normal ear canal and an ossicular chain. Of these patients, 7.05% had an air-bone gap closure within 20 dB. CONCLUSIONS: Long-term results of cavity reconstruction with hydroxyapatite are possible. The main problem is recurrent mucosal disease of the new middle ear-mastoid cleft.

Biocompatible Materials↗
PubMed1975

A method of stapedectomy in the fenestrated ear.

Two consequences of a previous fenestration militate against successful stapledectomy. They are the lessened depth of the middle ear over the stapes, and the missing incus. Twelve years' experience of using the stapedectomy for fenestrated ears in 62 patients has given generally disappointing results until, in 1962, technique of using cartilage blocks to increase the depth of the middle ear was devised.

Adult↗
PubMed1994

Middle-ear development. VI: Structural maturation of the rat conducting apparatus.

BACKGROUND: The contribution of middle-ear development to the overall development of hearing has not been explored in great detail. This presentation describes the maturation of conductive elements in the rat middle ear, and provides the basis on which future studies of middle-ear functional development will follow. METHODS: The middle-ear apparatus was examined at nine different ages (between 1 and 80 days postpartum) in Long Evans rats. At each age elements of the conducting apparatus was observed with either light or scanning electron microscopy (SEM), and quantitative measurements were made from video enhanced photomicrographs. Tympanic membrane area and cone depth, the length of the malleus and incus arms, ossicular weight, stapes foot plate and oval window areas, and bulla volume were all measured. Development of the area and lever ratios were derived from these measurements. The data were fitted to exponential equations and the time in days required to reach 90% of the adult level determined. RESULTS: The pars tensa achieved 90% of total area by 17 days. The oval window achieved the 90% criterion by 13 days, while the area ratio was within 10% of its adult size by 8 days. The ossicles took between 26 and 34 days, while bulla volume took 59 days to reach the 90% level. CONCLUSIONS: Middle-ear growth was very orderly and systematic in the data reported. When maturation of the area ratio was considered against development of the endocochlear potential or the round window compound action potential, it was clear that the growth of this important aspect of the middle ear preceded the onset of cochlear function.

Aging↗
PubMed1992

Hearing loss in Noonan syndrome.

A report is presented on a man of Turkish origin, with Noonan Syndrome and unilateral conductive hearing loss since early childhood. There was no history of otitis media. At the age of 23, exploratory tympanotomy revealed a total absence of the long process of the incus and a normal-looking tympanic membrane. The position of the normal-shaped mobile stapes was just medial, and not posteromedial, to the malleus. A congenital ossicular chain anomaly was diagnosed. An allograft malleus head was interposed between the stapes and the malleus. The resulting air-bone gap was less than 10 dB. A review of the literature is given on hearing loss in Noonan Syndrome.

Adult↗
PubMed1983

The influence of Mossbauer source size and position on phase and amplitude measurements of the guinea pig basilar membrane.

Phase and amplitude measurements were made from the incus and basilar membrane in guinea pig using the Mossbauer technique. The basilar membrane/incus ratio had a maximum of about 60 dB and a phase accumulation of between 9 and 12 radians to CF. Two source sizes were used (60 X 85 and 20 X 60 microns) and the source was placed either on the modiolar edge of the basilar membrane or in the middle. Notches in plots of the basilar membrane/incus ratio occur at stimulus frequencies that appear to be associated with source size rather than position, suggesting that artefacts could be produced by the presence of the Mossbauer source.

Animals↗
PubMed2006

[Malleostapedotomy in the pathology of the incudomalleolar complex combined with fixation of the stapes].

INTRODUCTION: Stapes fixation combined with disorders of the incudo-malleolar complex disorders requires a sound transmission reconstruction that often is difficult to solve. This circumstance can turn up in several pathologies and also in revision surgery for otosclerosis. PATIENTS AND METHODS: We present our experience with four patients that underwent to malleostapedotomy with removal of the malleus anterior ligament and the malleus anterior apophysis. RESULTS: We discuss the previous findings in each case. Two patients reached a gap closure and the other two patients obtained an auditive gain without complete gap closure. DISCUSSION: We set out the ethiology of malleus and incus hipomobility. We do a bibliographic review on the results of this technique in revision stapedectomy.

Female↗
PubMed1995

Sound pressure gain produced by the human middle ear.

The acoustic function of the middle ear is to match sound passing from the low impedance of air to the high impedance of cochlear fluid. Little information is available on the actual middle ear pressure gain in human beings. This article describes experiments on middle ear pressure gain in six fresh human temporal bones. Stapes footplate displacement and phase were measured with a laser Doppler vibrometer before and after removal of the tympanic membrane, malleus, and incus. Acoustic insulation of the round window with clay was performed. Umbo displacement was also measured before tympanic membrane removal to assess baseline tympanic membrane function. The middle ear has its major gain in the lower frequencies, with a peak near 0.9 kHz. The mean gain was 23.0 dB below 1.0 kHz, the resonant frequency of the middle ear; the mean peak gain was 26.6 dB. Above 1.0 kHz, the second pressure gain decreased at a rate of -8.6 dB/octave, with a mean gain of 6.5 dB at 4.0 kHz. Only a small amount of gain was present above 7.0 kHz. Significant individual differences in pressure gain were found between ears that appeared related to variations in tympanic membrane function and not to variations in cochlear impedance.

Acoustic Stimulation↗
PubMed1975

A case of salivary gland choristoma of the middle ear.

The authors present a case of tympanic cavity salivary gland adenochoristoma in association with an abnormal course of the facial nerve, absence of the oval and round windows, absence of the stapes, hypoplasia of the long process of the incus, and the existence of a subtympanic bony lamina.

Choristoma↗
PubMed1978

Salivary gland choristoma of the middle ear.

A case is described in which a middle-ear salivary gland choristoma was found in association with dehiscence of the horizontal part of the facial nerve and abnormality of the stapes and incus. It is suggested that these features may constitute an abnormal development syndrome.

Adult↗
PubMed1987

Anatomical variations and relations of the medical and lateral portions of the attic and their surgical significance.

The medial and lateral attics were examined in 150 specimens of temporal bones of adults using anatomical and histological methods. The medial attic varies in shape and size, depending upon the position of the auditory ossicles, the degree of prominence of the lateral semicircular canal and the direction in which the tympanic segment of the facial canal extends. The latero-medical diameter of this attic at the level of the body of the incus averages 1.7 mm., but is somewhat smaller at the level of the head of the malleus. The medial attic always communicates with the mesotympanum through an opening between the prominence of the tympanic part of the facial canal and the superstructures of the auditory ossicles. The lateral attic is always of smaller dimensions than the medial attic and its latero-medial diameter averages less than 1 mm. This attic very seldom communicates with the mesotympanum.

Adult↗
PubMed1990

Unusual case of bilateral conductive deafness.

A 30-year-old female presented with a ten-year history of bilateral conductive deafness. A pre-operative diagnosis of otosclerosis was made but at tympanotomy, the stapes crura in each ear was found to be disconnected from the footplate, the ossicular chain being otherwise normal. A Teflon-wire prosthesis was used to join incus and footplate, with good results. In the absence of a history of trauma or sepsis this may be a late presentation of a congenital stapedial anomaly which has not previously been reported.

Adult↗
PubMed1994

Cholesteatoma: ossicular destruction in adults and children.

The records of 148 adults (aged 14 years and older) presenting previously untreated aural cholesteatomas are analysed with particular emphasis on ossicular destruction and other bony lesions in the middle ear. The findings are compared with those obtained in an earlier study of 63 children (aged 13 years and younger), also with untreated cholesteatomas. The rate of stapes and malleus destruction was similar in adults and children. The rate of incus destruction was significantly higher in adults. Semicircular fistulas as well as facial paralysis were also more prevalent amongst adults. Therefore, the notion of childhood cholesteatoma aggressiveness cannot be related to its effect on these bony structures. It may stem from its higher recurrence rate and from the more troublesome post-operative mastoid cavities, which are often larger in children than in adults.

Adolescent↗
PubMed2006

Unusual middle-ear mischief: trans-tympanic trauma from a hair grip resulting in ossicular, facial nerve and oval window disruption.

A case of piercing of the tympanic membrane, resulting in unusual consequences, is described. This is the first reported case of the long process of a dislocated incus resulting in trauma to the horizontal portion of a dehiscent facial nerve. Simultaneous depression of the stapes footplate resulted in a perilymph leak, but with delayed presentation.

Accidents, Home↗
PubMed2003

A detailed subgross morphometric study on the auditory ossicles of the New Zealand rabbit.

This study was designed to reveal, in detail, the features of the auditory ossicles of the New Zealand rabbit, one of the most frequently used animals in scientific researches. Heads of 10 dead adult New Zealand rabbits of both sexes weighing 2.5 +/- 0.2 kg were used in the study. The auditory ossicles were gently removed from their situs and observed. The auditory ossicles were three small bones: the malleus, the incus and the stapes. The lenticular bone seemed to be the lenticular process, as is in human beings. In general, macroanatomic features of the bones were similar to those reported in the literature. Findings in this study, however, differed greatly, especially in detail. There were statistically significant differences in the morphometric data of the features of the auditory ossicles between the right- and left-hand sides. Data from the right-hand side were significantly higher.

Anatomy, Veterinary↗
PubMedDate not supplied

Laser-assisted tympanoplasty for preservation of the ossicular chain in cholesteatoma.

We report the use of potassium titanyl phosphate laser-assisted tympanoplasty in amputations of the malleus and incus in 2 patients with cholesteatoma medial to those ossicles that had not destroyed the ossicular chain continuity. In both cases, the laser successfully removed portions of the ossicles to allow removal of the cholesteatoma; importantly, the laser preserved certain ossicular ligaments, thus keeping the ossicular chain continuous. Postoperatively, both patients showed satisfactory hearing. Although the prevalence of cholesteatoma medial to the ossicles with maintained ossicular continuity is limited, the laser-assisted procedure described here is useful for maintaining hearing ability in these cases.

Adult↗
PubMed2004

[Bone ablation using ultrashort laser pulses. A new technique for middle ear surgery].

OBJECTIVES: Laser applications within the tympanic cavity area are widely accepted. Commonly used systems are CO(2), argon, KTP and erbium devices. The disadvantages are heat development and/or acoustic load of the inner ear. A new laser with ultra short pulses was examined concerning its ablation characteristics and tested for possible applications in the tympanic cavity. METHODS: Investigations on human ossicles and porcine compacta were performed with a femtosecond laser in order to determine the ablation parameters. This included measurements of the dependency of the threshold energy on the pulse duration and the determination of the ablation ratio using different pulse energy levels. On the basis of histological slices the thermal damages of the bone were examined. Additionally, the processed samples were analyzed with an optical microscope and with a scanning electron microscope in order to evaluate the quality of the perforations. RESULTS: The measurements showed that the threshold energy has a lower level than the threshold energy of the conventional laser systems. At a pulse duration of 180 fs the smallest fluence, with which an erosion can be achieved, is below 1 J/cm(2). With increasing pulse duration the necessary threshold energy also rises. Due to the low energy level necessary for ablation and the extremely short pulse duration, less thermal damage is induced to the surrounding bone tissue as compared to conventional laser systems. The analysis of the scanning electron microscope demonstrates the extreme precision of this laser system. The achieved accuracy of the incisions and drillings ranges in the microm-area. CONCLUSIONS: The fs laser represents a new surgical tool for middle ear surgery. It works efficiently and in a touch-free procedure. Due to its high precision and the reduced side effects an advantage in the handling of bony structures is to be expected in relation to other laser systems. Apart from the perforation of the stapes footplate, in particular the handling and modelling of the incus, a further field of applications includes enhanced coupling, e. g. for implantable hearing aids and ossicular chain replacement prosthesis.

Animals↗
PubMed1998

The value of methylprednisolone in the treatment of an experimental sensorineural hearing loss following drill-induced ossicular chain injury: a randomized, blinded study in guinea-pigs.

In a previously established animal model a standardized drill-induced injury to the body of the incus was applied, and the effects on hearing were characterized by electrocochleography. In a placebo-controlled, randomized, blinded study methylprednisolone showed no protective effect in reducing or improving the auditory threshold shifts, which occurred within seconds after drilling and remained stable throughout the 5-week observation period. Therefore the otologic surgeon must pay close attention to avoiding any contact of a rotating burr with an ossicle in an intact ossicular chain.

Animals↗
PubMed1984

Five-year evaluation of reconstructive tympanoplasty using a goblet prosthesis.

This article reviews tympanoplasty using a stainless steel goblet alloplastic prosthesis with a repositioned incus and presents a five-year follow-up report on 51 patients who had this kind of ossicular chain reconstruction. The five-year evaluation shows a better than average success rate compared with other allographic and alloplastic materials.

Chronic Disease↗